[Combined operations on vessels and abdominal organs]. / Sochetannye operatsii na sosudakh i organakh bryushnoi polosti.

THE AIM OF THE STUDY: Is to describe the experience of combined operations and the expediency of choosing such a tactic for surgical treatment of patients with two or more surgical diseases. MATERIAL AND METHODS: The results of surgical treatment of 299 patients with vascular lesions in combination with other diseases requiring surgical treatment in 2014-2018 were analyzed. All operations were performed in the cardiovascular department of the GBUZ RKB on the basis of the Department of Hospital Surgery of the KBSU named after V.I. H.M. Berbekov. In the selected group, the proportion of patients of working age was 71%. Combined operations were performed in 151 patients, the remaining 148 people who underwent surgery for cardiovascular and surgical diseases were included in the comparison group. Among them, a combined operation was performed in 79 patients for vascular diseases and in 69 for other diseases. RESULTS: When analyzing the perioperative period in patients of the main and control groups, there was no significant difference in the parameters of simultaneous surgical interventions (duration of operations, volume of blood loss, the need to increase the dose of catecholamines in the operating and postoperative periods, the incidence of rhythm and conduction disturbances, the duration of artificial ventilation and stay in hospital). It was found that combined operations did not lead to an increase in the number of postoperative complications and an increase in mortality. At the same time, combined operations are possible even with a complex combination of various diseases. CONCLUSIONS: Combined operations are more justified than staged surgical treatment: 1) the patient is simultaneously cured of 2 or more surgical diseases; 2) the risk of repeated general anesthesia and its negative consequences is eliminated; 3) re-examination and preoperative preparation are excluded; 4) the frequency of progression and recurrence of diseases (infringement of a hernia, exacerbation of cholecystitis, etc.), repeated surgical interventions for concomitant diseases decreases; 5) a single access simplifies the surgical approach to the abdominal organs and is less traumatic; 6) the average time spent by the patient in the hospital, the terms of further rehabilitation and the period of incapacity for work are reduced; 7) combined surgical interventions are economically beneficial.

[Permanent vascular accesses in patients with chronic renal failure undergoing hemodialysis].

The article presents an experience of arteriovenous fistulas forming and using in 78 patients with end-stage chronic renal failure undergoing hemodialysis. New methods for permanent vascular accesses forming were suggested. These techniques increased the operation period of arteriovenous fistulas.

[Experience in treatment of critical lower limb ischaemia on the background of diffuse arterial lesions].

The article deals with general statistical data on surgical treatment of chronic critical lower limb ischaemia on the background of diffuse arterial lesions. Also presented herein is an interesting clinical example of revascularization of a lower limb in diffuse arterial lesions by means of atypical bypass grafting.

[Successful outcome of treatment for a ruptured abdominal aortic aneurysm accompanied by inguinal hernia: a clinical case report].

The article deals with a clinical case report concerning surgical management of a male patient presenting with a ruptured abdominal aortic aneurysm. The postoperative period was complicated by strangulation of inguinal hernia inadvertently neglected during prior surgery, however then treated successfully by tension-free hernioplasty, with due conclusions eventually drawn.